October 31, 2018

How to Protect Your Heart When You Have Prediabetes

Tips to counter higher risk of heart attack, stroke

A close-up of a finger with a blood test strip.

If your doctor says you have prediabetes, it means your blood sugar is high but not quite to the level of diabetes. You may feel like you’re in the clear for now, but the truth is you’re already at higher risk for heart attack and stroke with prediabetes blood sugar levels.


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It’s pretty well known that high blood sugar can have an impact on your kidneys and blood vessels. So now is the best time to take steps to address those risks and protect your heart.

Here’s what you need to consider when it comes to protecting your heart when your blood sugar is even a little high.

Prediabetes by the numbers

A diagnosis of prediabetes typically means your blood sugar levels are:

  • Hemoglobin A1C between 5.7 and 6.4%
  • Fasting blood sugar between 100 and 125 mg/dL
  • Glucose between 140 and 199 mg/dL (in a glucose challenge test)

Cardiologist Monica Khot, MD, calls these levels “a yellow light warning signal.” If they get any higher, you are in the range for diabetes.

What are the risks?

Although you may not have diabetes, being on the border can set off unhealthy changes in your body.

Prediabetes is one part of metabolic syndrome, which increases your risk of blood clots and damage to coronary arteries. This may lead to cardiovascular disease and stroke.

A 2016 study published in the British Medical Journal analyzed records of more than 1 million people and found that those with prediabetes:

  • Were 13% more likely to have cardiovascular disease.
  • Had a 10% higher risk of coronary artery disease.
  • Were 6% more likely to have a stroke.

Even those with A1C levels just below prediabetes were more likely to have the first two conditions.


Taking control to protect your heart

If you have prediabetes, there are many things you can do to protect your heart.

1. Start with a focus on the basics.

“First, you have to get your other basic risk factors for heart disease under control,” Dr. Khot says, including:

2. Eat more fruits, vegetables and whole grains.

Dr. Khot recommends eating foods that have a low glycemic index to avoid increasing blood sugar levels further.

The glycemic index tells you how quickly foods with carbohydrates will raise blood sugar. The lower food is on the scale, the better.

“For instance, eating an orange is better than drinking juice because the body has to do more work to get to the sugar, and the sugars are then distributed more evenly,” Dr. Khot says. “If you watch your sugars, your numbers will start to go down from the yellow light to the green light.”

3. Get moving.


Exercise is also a great way to reduce your risk of heart disease.

If your weight is normal, Dr. Khot recommends walking 30 minutes a day, five to six days a week.

If you need to lose weight, try to get in an hour of walking about six days each week. “Data show you really need to walk more than 30 minutes a day to start losing weight,” she says.

Prediabetes often comes on without any symptoms (though some people notice skin darkening in the armpits, elbows or knees). But it’s important to know early if your blood sugar levels are creeping up so you can take steps to avoid moving into diabetes — and protect your heart and blood vessels.

Seeing your doctor for a yearly physical is the best way to keep an eye on your blood sugar levels over time. Or, if you have concerns about prediabetes, make an appointment for a blood sugar test now.

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